ratio's with induced hypothermia patients

  1. Poll: Are your induced hypothermia patients kept 1:1 throughout cooling/maintenance and rewarming?

    Thanks in advance
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    About **LaurelRN

    Joined: Jan '08; Posts: 94; Likes: 90
    RN; from US
    Specialty: 6 year(s) of experience in Open Heart ICU

    30 Comments

  3. by   Sugarcoma
    Our hypothermia patients are one to one for induction and once they reach goal temp the nurse can get another patient, but not an admit. During maintenance they are doubled. Singled again for re-warming. The last few months at my facility has seen lots of short staffing so nurses have been doubled during both induction and re-warming but we try very hard to stick to the ratios.
  4. by   ICUNurseStat
    Ours are 1:1 the whole time until they are rewarmed.
  5. by   mcubed45
    Ours are never 1:1 at any point.

    We use the Coolguard. The patient can initially be a little busy (like any admission) but once they're hooked up there's not all that much to do that would warrant 1:1. Maybe labs every couple hours with replacements, but nothing too crazy.

    Is this something new for your hospital? I know some local hospitals used to have them be 1:1 when the staff was first learning the whole hypothermia protocol and getting familiar with the equipment. Now they're just another ICU patient.
  6. by   StayLost
    Same here - 1:1 the whole time
  7. by   Biffbradford
    How would you like to have your family member experience a life threatening heart attack so bad that they have to sedate and cool you down to unnatural levels, yet the nurse has OTHER chores that may have priority? Isn't that crazy??
  8. by   MunoRN
    Quote from Biffbradford
    How would you like to have your family member experience a life threatening heart attack so bad that they have to sedate and cool you down to unnatural levels, yet the nurse has OTHER chores that may have priority? Isn't that crazy??
    There's probably a good reason we don't staff by that rationale. I think most people would want their family member to be the nurse's only patient, whether it's a kidney stone or TH.
  9. by   btab3
    Quote from MunoRN
    There's probably a good reason we don't staff by that rationale. I think most people would want their family member to be the nurse's only patient, whether it's a kidney stone or TH.
    +1 too that. patients and their family even think that they have priority when asking for water or something else.
  10. by   MunoRN
    Ideally all patients get more nursing attention than they currently do. But relative to other patients I don't consider TH patient to be any more nursing intensive once they've reached goal temp than a new sepsis admit, an open heart that extubated but still day of surgery, or even a DKA admit or GIB.

    We used to staff 1:1 when TH was new to us, but now it's just through the cooling phase which is fine with me, if it takes some of the load off nurses who have patients that are actually busier then it would seem that's appropriate, particularly if one of those other nurses happens to be me.
  11. by   nightshift82
    1:1 until rewarmed
  12. by   Dodongo
    They're never 1:1 in our ICUs if the only reason for doing so would be because they are inducing hypothermia. I don't see why that intervention alone would warrant it. The machine does all the work for you, really. Now if they are on multiple pressors, unstable arrhythmias, etc, they can be 1:1. The only things that really get you automatically 1:1 are CRRT, ECMO... um... fresh open hearts... I think that's about all.
  13. by   river_song
    The facility that I am currently at is 1:1 until rewarming
  14. by   AnthonyD
    Ours are 1:1, usually the whole time. On a rare occasion, they are paired during maintenance phase.

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